CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $158
Cash Discount Price: $299
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Independence Health System Butler Memorial Hospita is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $299. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.25x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

$299

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)

Cash / Self-Pay: $299 (237%)

Insurance Median: $158 (125%)

Cash: $299 (237% of Medicare)

Ins. Median: $158 (125% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Highmark	$80 - $175	63%
Highmark - Ind.& Managed Care	$80 - $195	63%
Highmark Aca - Direct Blue	$80 - $109	63%
Highmark Community Blue	$80 - $172	63%
Life Butler County	$83	66%
Martin'S Point - Usfhp	$83 - $149	66%
Medicare (plans)	$83	66%
Peak Health	$83 - $299	66%
Provider Partners	$83	66%
Tricare	$83	66%
UnitedHealthcare	$83 - $105	66%
Aetna	$86 - $342	68%
Humana	$86	68%
Amerihealth	$87 - $115	69%
Geisinger	$87 - $427	69%
Devoted Health Plan	$88 - $171	70%
The Health Plan	$88 - $195	70%
Pa Health & Wellness	$89	70%
Gateway	$90 - $448	71%
American Health Plan	$91	72%
Pnoa	$91 - $342	72%
Medicaid / KanCare	$105	83%
Upmc	$109 - $448	86%
Jefferson Health Plan	$115	91%
Ellwood Group	$128 - $184	101%
Cigna	$208 - $214	165%
Ccbh - Behavioral Health	$214 - $406	170%
Private Healthcare Systems	$299 - $363	237%
Devon	$320	253%
Intergroup	$342	271%
Multiplan	$384	304%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $299.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Independence Health System Butler Memorial Hospita is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.